Acute Flaccid Myelitis (AFM)

Client Notes:

Link to the CDC for Acute Flaccid Myelitis

AFT CLINICIAN AID

Acute Flaccid Myelitis (AFM) Fact Sheet 

ISDH Alert 10/17/18

Specimen Requirements

2  (> 1) Grams Whole Stool in a Sterile Gray 

Alternate Specimen

Specimen Type	Minimum Amount	Collection	Storage	Shipping	Comments
Cerebrospinal fluid (CSF)	1 mL	Spun and processed; standard cryovial tube; collect at same time or within 24 hours of serum if feasible	Freeze at -20°C	Ship on dry ice	CSF will be used for special studies; EV/RV testing will be batched and results returned as sample amount allows
Serum*	0.4 mL	Spun and processed; Tiger/red top tube; collect at same time or within 24 hours of CSF if feasible.	Freeze at -20°C	Ship on dry ice	Serum will be used for special studies; no individual results will be returned
Respiratory – nasopharyngeal (NP) or oropharyngeal (OP) swab	1 ml	Store in viral transport medium	Freeze at -20°C	Ship on dry ice	EV/RV testing and typing will be performed and results returned within 10 days of sample receipt
In the event of death, please send the following specimens, if possible
Fresh-frozen tissue		Place directly on dry ice or liquid nitrogen	Freeze at -70°C	Ship on dry ice	Representative sections from various organs are requested, but particularly from brain/spinal cord (including gray and white matter), heart, lung, liver, kidney, and other organs as available.
Formalin-fixed or formalin-fixed, paraffin-embedded tissue		Avoid prolonged fixation—tissues should have been fixed in formalin for 3 days, then transferred to 100% ethanol	Room temperature	Ship at room temperature with paraffin blocks in carriers to prevent breakage	See comment above regarding frozen tissue

TransportAndStorage

Freeze at -20°C
Ship on dry ice

Collection Instructions

Collect in sterile container, no special medium required. Please do not send a rectal swab

Two samples total, collected at least 24 hours apart, both collected as early in illness as possible and ideally within 14 days of illness onset. Results for EV/RV and poliovirus testing will be returned as testing completed (within 14 days)

Minimum Volume

Neonatal Volumne

Reference Range:

See Interpretive Report

Methodology:

• Unknown

CPT Coding

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